Robin Roberts Has Myelodysplastic Syndromes -- What Is That?
On Monday, we learned that Robin Roberts, anchor of ABC’s Good Morning America, has been diagnosed with MDS, or myelodysplastic syndromes.
“Talk about your highs and lows!” she said, after disclosing that she learned of the diagnosis on the same day that she found out that for the first time in 16 years, Good Morning America had broken past NBC’s Today show in the ratings.
Robin Roberts, photo by Ken Babolocsay (Globe Photos/ZUMAPRESS.com)
“I’ve always been a fighter, and with all of your prayers and support, a winner,” Roberts reassured fans in a statement.
WHAT IS MDS?
Myelodysplastic syndromes include a variety of hematological disorders, or disorders of the blood.
“If you break it up, myelo means bone, dysplasia means the cells within the bone – or bone marrow –look abnormal,” says Ruben Mesa, a hematologist at Mayo Clinic in Arizona. ”What this represents is a disease, as we believe at this point in time, where the bone marrow is not well enough for the creation of the blood cells that you need out in your bloodstream.”
Essentially, the blood cells created by the defective bone marrow do not develop normally, either dying in the marrow or upon entering the bloodstream. As time goes on, the number of defective or immature cells overwhelms that of healthy cells in the bloodstream.
WHAT CAUSES MDS?
Meylodysplastic syndromes happen when the production of healthy blood cells is disrupted in the bone marrow. This can occur by exposure to radiation or chemicals such as benzene, toluene, xylene, and chloramphenicol, heavy metals, herbicides, pesticides, fertilizers, nitro-organic explosives, petroleum and diesel derivatives, and radiation therapy and alkylating agents associated with cancer therapy. Such exposure can lead to mutations in the hematopoietic stem cells, the stem cells responsible for developing the various types of blood cells.
Roberts, who was diagnosed with breast cancer in 2007, completed her chemotherapy and radiation treatments in 2008. Her diagnosis of MDS comes five years after she began her battle with cancer.
“Sometimes the treatment for cancer can cause other serious medical problems,” Robins said in her statement.
WHAT ARE THE SYMPTOMS OF MDS?
Myelodysplastic syndromes rarely show symptoms in early stages, and these tend to be nonspecific. Signs of anemia, such as chronic fatigue, shortness of breath and pallor, may surface in time, signaling an issue with red blood cells. Easy bruising and usual bleeding might suggest an issue with platelets, or thrombocytes. An increased frequency of infection signifies a problem with the white blood cells called neutrophil granulocytes. That said, many people exhibit no symptoms at all.
There are two main categories of myelodysplastic syndromes: those with an unknown cause and those that occur in response to exposure, such as cancer treatments like chemotherapy and radiation. Within these categories, the World Health Organization recognizes the following types of myelodysplastic syndroms:
Refractory cytopenia with unilineage dysplasia: low count of a certain type of blood cell. Under a microscope these cells appear abnormal.
Refractory cytopenia with multilineage dysplasia: two types of blood cells are abnormal. Less than one percent of these cells in the bloodstream are immature.
Refractory anemia with ringed sideroblasts: low count of red blood cells. Upon examination, the red blood cells that exist show excess amount of iron.
Refractory anemia with excess blasts (type I and type II): a low count and abnormal appearance of any of the three types of blood cells. Blood analysis reveals immature blood cells in the blood, in type I, it is five to nine percent, and in type II, 10 to 19 percent.
Myelodysplastic syndrome, unclassifiable: a reduced number of anyone of the three types of blood cells, and either the white blood cells or platelets look abnormal under a microscope.
Myelodysplastic syndrome associated with isolated del(5q) chromosome abnormality: low numbers of red blood cells, and these cells have a specific defect in their DNA.
Concerns with this system of categorization exist as the medical community continue to work toward understanding this complex collection of blood-related conditions. To read about the history of MDS’ history of cellular classification, please visit National Cancer Institute.
The most serious complication is a form of acute myelogenous leukemia that is particularly resistant to treatment, but 50 percent of deaths associated with MDS occur from its complications: susceptibility to infection and excessive bleeding.
HOW IS MDS TREATED?
Three types of treatments are available to patients suffering MDS.
- Supportive care is given to relieve symptoms and slow progression of the disease. Often, this includes transfusion therapy, which replenishes the blood cells. Because blood transfusions may lead to iron overload in a patient’s body, drugs are sometimes used in combination to lessen the necessary number of transfusions.
- Growth factor therapy helps increase the number of blood cells and reduces the effects of anemia.
- Chemotherapy uses drugs to destroy the defective blood cells and otherwise stop them from dividing.
- Stem cell transplant is a method of replacing the stem cells lost by treatment. Stem cells are removed from the blood or bone marrow of a donor and given to the patient through infusion after the patient completes a round of chemotherapy to destroy the problem cells.
Robin Roberts plans to have a transplant. Her older sister, Sally-Ann Roberts is almost a perfect match and will be donating bone marrow for a transplant scheduled to occur later this summer or in the fall.
“Today, I will start what is known as pre-treatment – chemotherapy in advance of a bone marrow transplant later this year,” Roberts said in a statement. “Bone marrow donors are scarce and particularly for African-American women. I am very fortunate to have a sister who is an excellent match, and this greatly improves my chances for a cure. As you know from my recent interview with Mark Zuckerberg, organ donation is vitally important. Many people don't realize they can be bone marrow donors. I encourage everyone to sign up on a donor registry like bethematch.org.”